Discussion : Novel expandable short dental implants (4)
In relation to the results by McCullough and Klokkevold, who found that the macrothread design appears to play a positive role in implant stability in the early healing period, this can also be assumed for the employed implant system.
Additionally, with regard to the results by Marković and co-authors, a critical stability drop down due to bone remodeling after bone condensing (implant site preparation and/or using expandable implants) should not be suspected; the opposite can be expected. The authors analysed the implant stability (4.1 × 10-mm screw implant) in the posterior maxilla in vivo depending on the implant site preparation (bone condensing vs. bone drilling) and confirmed that, after bone condensing, significantly higher implant stability results were achieved, immediately after implant insertion as well as during the whole observation period of 6 weeks. Especially in the third week in both groups, the following results were measured: 66.7 ± 1.64 vs. 57.1 ± 1.45 (p < 0.001). In the present study, we measured in the posterior maxilla 66.3 ± 10.4 ISQ units for primary stability and 66.9 ± 12.0 ISQ units for secondary stability, respectively.
Contrary to conventional hollow-screw implants (only marginal gap), a problem of the expandable implant is the presence of gaps down to the apical region. Former microbial assessment of different implant-abutment interfaces displayed that none of the marginal connections had the capacity to prevent microbial leakage. Therefore, an apical microleakage (comparable to distractable implants and endodontically treated teeth) might be a disadvantage of the evolved implant system. However, according to the manufacturer’s information, a microbiological study revealed no microbial leakage through the expanded implants. Over the follow-up period, we equally did not observe any inflammatory signs in the apical region, neither clinically nor radiologically (Figs. 4b and 5c-d). Nevertheless, this aspect should be analysed under mechanical loading in vitro.
Serial posts:
- Novel expandable short dental implants with reduced vertical bone height
- Introduction : Novel expandable short dental implants (1)
- Introduction : Novel expandable short dental implants (2)
- Material & methods : Novel expandable short dental implants (1)
- Material & methods : Novel expandable short dental implants (2)
- Results : Novel expandable short dental implants (2)
- Discussion : Novel expandable short dental implants (1)
- Discussion : Novel expandable short dental implants (2)
- Discussion : Novel expandable short dental implants (3)
- Discussion : Novel expandable short dental implants (4)
- Discussion : Novel expandable short dental implants (5)
- Table 1 Patient recruitment
- Table 2 Surgical treatment protocol
- Table 3 Prosthetic treatment protocol
- Table 4 Clinical characteristics of the study cohort
- Figure 1. a Closed short expandable dental implant
- Figure 2. Cumulative implant survival over the follow-up period
- Figure 3. a Primary implant stability
- Figure 4 a–h Prosthetic restauration—follow-up examination. Intraoral and perioral views of a rehabilitated female patient. (She asked explicitly only for implantological treatment in the mandible.)
- Figure 5 Postoperative orthopantomogram